The World of People With Schizophrenia
cont. from
- Distorted Perceptions of Reality
People with schizophrenia may have perceptions of reality that are strikingly
different from the reality seen and shared by others around them. Living in a
world distorted by hallucinations and delusions, individuals with schizophrenia
may feel frightened, anxious, and confused.
In part because of the unusual realities they experience, people with
schizophrenia may behave very differently at various times. Sometimes they may
seem distant, detached, or preoccupied and may even sit as rigidly as a stone,
not moving for hours or uttering a sound. Other times they may move about
constantly – always occupied, appearing wide-awake, vigilant, and alert.
- Hallucinations and Illusions
Hallucinations and illusions are disturbances of perception that are common
in people suffering from schizophrenia. Hallucinations are perceptions that
occur without connection to an appropriate source. Although hallucinations can
occur in any sensory form – auditory (sound), visual (sight), tactile (touch),
gustatory (taste), and olfactory (smell) – hearing voices that other people do
not hear is the most common type of hallucination in schizophrenia. Voices may
describe the patient’s activities, carry on a conversation, warn of impending
dangers, or even issue orders to the individual. Illusions, on the other hand,
occur when a sensory stimulus is present but is incorrectly interpreted by the
individual.
Delusions are false personal beliefs that are not subject to reason or
contradictory evidence and are not explained by a person’s usual cultural
concepts. Delusions may take on different themes. For example, patients
suffering from paranoid-type symptoms – roughly one-third of people with
schizophrenia – often have delusions of persecution, or false and irrational
beliefs that they are being cheated, harassed, poisoned, or conspired against.
These patients may believe that they, or a member of the family or someone close
to them, are the focus of this persecution. In addition, delusions of grandeur,
in which a person may believe he or she is a famous or important figure, may
occur in schizophrenia. Sometimes the delusions experienced by people with
schizophrenia are quite bizarre; for instance, believing that a neighbor is
controlling their behavior with magnetic waves; that people on television are
directing special messages to them; or that their thoughts are being broadcast
aloud to others.
Substance abuse is a common concern of the family and friends of people with
schizophrenia. Since some people who abuse drugs may show symptoms similar to
those of schizophrenia, people with schizophrenia may be mistaken for people
"high on drugs.” While most researchers do not believe that substance abuse
causes schizophrenia, people who have schizophrenia often abuse alcohol and/or
drugs, and may have particularly bad reactions to certain drugs. Substance abuse
can reduce the effectiveness of treatment for schizophrenia. Stimulants (such as
amphetamines or cocaine) may cause major problems for patients with
schizophrenia, as may PCP or marijuana. In fact, some people experience a
worsening of their schizophrenic symptoms when they are taking such drugs.
Substance abuse also reduces the likelihood that patients will follow the
treatment plans recommended by their doctors.
- Schizophrenia and Nicotine
The most common form of substance use disorder in people with schizophrenia
is nicotine dependence due to smoking. While the prevalence of smoking in the
U.S. population is about 25 to 30 percent, the prevalence among people with
schizophrenia is approximately three times as high. Research has shown that the
relationship between smoking and schizophrenia is complex. Although people with
schizophrenia may smoke to self medicate their symptoms, smoking has been found
to interfere with the response to antipsychotic drugs. Several studies have
found that schizophrenia patients who smoke need higher doses of antipsychotic
medication. Quitting smoking may be especially difficult for people with
schizophrenia, because the symptoms of nicotine withdrawal may cause a temporary
worsening of schizophrenia symptoms. However, smoking cessation strategies that
include nicotine replacement methods may be effective. Doctors should carefully
monitor medication dosage and response when patients with schizophrenia either
start or stop smoking.
continue: Disordered Thinking
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Reviewed: 03/2006
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